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i <br /> A Results of Testing/Servicing <br /> r <br /> Software Version Installed:_/ZZ. C C0 <br /> Complete the following checklist: <br /> Yes ❑ No* Is the audible alarm operational? <br /> A Yes ❑ No* Is the visual alarm operational? <br /> Yes ❑ No* Were all sensors visually inspected, functionally tested, and confirmed operational? <br /> Yes ❑ No* Were all sensors installed at lowest point of secondarypontainnunt and_.,positioned so that other equipment will <br /> not interfere with their proper operation? <br /> - ` <br /> ❑ Yes If alarms area reldytd- to-.a' remote monitoring station, is sll do Anic`tions equipment (e.g. modem) <br /> N/A, Aperational? •.�.��1 <br /> Yes 0 No* For pressurized piping systems,-does;the�ltrrbine•automatically shpt down if the piping secondary containment <br /> L3 N/A' monitoring system detects a leak, fails to operate, or is electrically disb�nected? If yes: which sensors initiate <br /> positive shut-down? (Check all that apply)A Sump/Trench Sensors; Dispenser Containment Sensors. <br /> Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 16 Yes; ❑No. <br /> Yes ❑ No* For tank systems that utilize the monitoring system as the primary talik'overfill'warning device (i.e. no <br /> ❑•N/A' mechanical overfill prevention valve is installed)js the oJ�r rrVarning alarm visible and audible at the,tank <br /> fill point(s)and operating If so,at what 'percent of tank gapacity capacitydoes the alarm trigger? O % <br /> ❑ Yes* Uff No Was any monitoring equipment replaced? If yes identify specific sensors,probes, or other equipment replAced <br /> and list the manufacturer name and model for all re iacement arts in Section E,below. <br /> ❑ Yes* 8 No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ❑ <br /> Product; ❑ Water. If yes,describe causes in Section E,below. <br /> X-yes ❑ No*. Was monitoring system set-up reviewed to ensure proper settings?Attach set!T.r -or4s,if applicable <br /> lb Yes ❑ No*. Is all monitoring equipment oerational per manufacturer's s e ' cations? <br /> * In Sec:,on E below,describe how and when these deficiencies were or will be corrected. <br /> E. Co ments• <br /> Y' a, <br /> Page 2 of 3 03/01 <br />